As noted in earlier NPQ stories, the American Health Care Act, passed by the House in March 2017, proposes to cut federal Medicaid spending by more than $800 billion over the next decade by imposing a per-capita cap on spending. President Trump’s budget proposal suggests that we could see even deeper cuts, totaling over a trillion dollars, to this vital program.

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According to the Kaiser Family Fund, over 22 million non-elderly adults living in communities across the U.S. have a disability. For about one third, or 7 million of these adults with disabilities, Medicaid is an essential resource, often complementing either Social Security’s SSI or SSDI program benefits. Medicaid provides not just healthcare coverage but an array of personal supports that make it possible to live independently.

People living with disabilities have been fighting for the right to live in the community, with appropriate supports and services, since the 1960s. July marks the 18th anniversary of the Supreme Court Olmstead decision, which established that people with disabilities have the right to services that allow them to live “in the most integrated setting possible.”

Georgia (and all states) will have to make tough choices—either cutting back on eligibility for services, reducing the types of services available to people with disabilities, or reducing reimbursement to providers. Currently, Georgia receives $2 from the federal government for every $1 it spends on services for people with disabilities.

Without federal Medicaid dollars, states are likely to pull back on these programs, which fall under the Medicaid “state option,” meaning they are not Medicaid entitlements.

The future is unclear as to what the outcome will be with so many Americans being supported by the Medicaid funding, however one this is certain: our system needs to progress in order to keep up.

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